CVS Caremark-sponsored research examines impact of social support network on Rx adherence

By Antoinette Alexander

WOONSOCKET, R.I. — A patient’s social support network has been associated with improved outcomes and healthier behaviors and now new research sponsored by CVS Caremark has found that practical social support is associated with improved medication adherence.

"The growing popularity of online social networking has raised the question of how social connectedness can impact a person's health and whether it plays any role in improving medication adherence," stated Niteesh K. Choudhry, associate physician in the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women's Hospital, and associate professor of Harvard Medical School. "Our research suggests that leveraging a patient's existing social contacts and networks to help them with the practical aspects of being adherent, such as providing transportation to the pharmacy or picking up medications for the patient, could be both an effective and cost-effective way to help improve adherence."

The clinical and financial impact of medication non-adherence on the U.S. health care system — estimated at nearly $300 billion a year — has motivated numerous researchers to evaluate interventions to identify cost-effective best practices to address the issue. In addition, while a patient's social support network has been associated with improved outcomes and healthier behaviors, the role a patient's social connections and networks can play in improving medication adherence has not been well defined. Now, the new research sponsored by CVS Caremark has found that practical social support is associated with improved medication adherence.

The study, entitled Association Between Different Types of Social Support and Medication Adherence, was conducted by researchers at Harvard University, Brigham and Women's Hospital, and CVS Caremark and was published in the December 2012 issue of the American Journal of Managed Care.

The researchers reviewed 50 peer-reviewed articles about studies which directly measured the relationship between medication adherence and some form of social support. Four categories of social support for patients were identified and evaluated: structural, practical, emotional and a combination approach. The results indicate that greater practical support was more consistently associated with improved adherence to medication, with the majority of studies evaluating practical support (67%) identifying a significant association between the social support and medication adherence.

"This study is part of our ongoing research collaboration with Harvard and Brigham and Women's Hospital to better understand the factors that impact medication adherence," stated Troyen Brennan, EVP and chief medical officer of CVS Caremark, who heads the research initiative that conducted the study. "While more research is needed to identify how best to apply these findings to patient care, these results suggest that practical support from a patient's social network of family and friends can be a simple and cost effective way to improve medication adherence and chronic disease management for patients."

The four categories of social support identified in the research include:

Structural support — marital status, living arrangements and size of the patient's social network;